Incontinence or Leakage

What is it?

Incontinence is defined as any unintended leakage from the bladder or bowel. It can occur for a variety of reasons and unfortunately affects 1 in 3 women and 1 in 9 men.

There are five primary types of incontinence:

1. Stress Incontinence: involuntary leakage that occurs as a result of increased intra-abdominal pressure (coughing, laughing, sneezing, physical activity)
2. Urge Incontinence: involuntary leakage that occurs when there is a strong, uncontrollable need to void (while walking to the washroom, when the toilet becomes visible, or as soon as any urge is felt)
3. Mixed Incontinence: involuntary leakage that occurs as a result of both increased intra-abdominal pressure and an intense urge to void (a mix of stress and urge incontinence)
4. Overflow Incontinence: involuntary leakage that occurs as a result of the bladder not emptying properly and becoming too full or overstretched (distended bladder)
5. Functional Incontinence: involuntary leakage that occurs as a result of not being able to access a washroom (cognitive, physical, psychological, or environmental barriers to a working toilet)

Unfortunately, there are still a lot of jokes and cultural norms surrounding incontinence. Patients are told that leakage is inevitable after a certain age or certain life experiences. It is important, however, to recognize that although incontinence may be common, it is never normal

While common risk factors such as aging, abdominal / pelvic surgery, pregnancy, and childbirth can increase one's chance of experiencing leakage, it does not have to stay that way. There is always something that can be done to help correct the issue!

How can Pelvic Floor Physiotherapy help?

Studies show that Pelvic Floor Physiotherapy is vastly superior to other forms of incontinence care, such as medication and surgery. It should be used as the first line of defence against leakage, and begin with identifying the type and root cause of the incontinence. Assessment and treatment will often include a combination of manual therapy, toileting education, lifestyle modifications, and breathing exercises.

Depending on individual needs, patients may need to practice stretching or lengthening pelvic floor muscles before beginning a strengthening program. A strengthening program will focus on retraining the muscles of the pelvic floor to work in better coordination with the other muscles of the deep core. Treatment plans will also include education and exercise designed to help normalize intra-abdominal and intra-pelvic pressures, thus making it easier for the pelvic floor to prevent incontinence.

Additional work may be indicated in the area of lifestyle and diet. Some diets cause inflammation of the digestive system and preclude the colon from being able to properly absorb liquid from consumed food. This will inevitably lead to very liquid stool that leaks from the rectal area regardless of the strength of the pelvic floor muscles. In this case, it is best to consult with a primary healthcare provider, modify diet, and discontinue the consumption of inflammatory foods. Once diet has stabilized, any remaining incontinence issues may be addressed by Pelvic Floor Physiotherapy.